Provider Demographics
NPI:1588783039
Name:LUCKS, STEVEN J (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:LUCKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4820 ARMOUR RD
Mailing Address - Street 2:SUITE A-7
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-5296
Mailing Address - Country:US
Mailing Address - Phone:706-320-9959
Mailing Address - Fax:706-320-9950
Practice Address - Street 1:4820 ARMOUR RD
Practice Address - Street 2:SUITE A-7
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-5296
Practice Address - Country:US
Practice Address - Phone:706-320-9959
Practice Address - Fax:706-320-9950
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA047481207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1689757379OtherNPI FOR ARMOUR ROAD FAMIL
GAC24620Medicare UPIN
GA1689757379OtherNPI FOR ARMOUR ROAD FAMIL